Thursday, January 05, 2006

Bird Flu And Reality

Turkey has confirmed two cases of human bird flu. One child has died. Another is critical. At least six were hospitalized at the same time with the same symptoms, so I think the likelihood is that they will be confirming more cases. The implication for the west is immense. We don't have any natural immunities to this virus (whereas the Asian populations living in close proximity to H5N1 bird populations must by now), and recent studies have shown that other bird flus that were not pathogenic in humans spread through hundreds of humans.

Unlike every medical authority out there, I believe that a 1918-like strain of this virus could only erupt in the west because to survive in Asia it would have to evolve into a less pathogenic form (evading herd immunity), while if it goes human-to-human in the west it need not. And so the other shoe drops and I would imagine Europe will abruptly become serious if Europe's rooted habits of self-delusive reworkings of reality are not too greatly engrained.

But are we serious? The results of the bird surveillance tests from Alaska have not yet been published. This virus will spread through the bird and animal population of the Americas with incredible speed, and I believe it is already here.

We had buckets of rain a couple of days ago and our land was flooded. A flock of egrets flew in and spent the day foraging in the flooded winter wheat. That flock has now flown off. If the sick juvenile Ross Goose has H5N1 and has shed enough virus, it is likely that the egrets will carry the disease to other areas. This is what water birds do. If I'm right, around March you will see massive die-offs of water fowl in parts of the US.

Have the blood banks considered testing for H5N1? If not, we have a huge vulnerability there. Even if they will test, do we have good enough tests to detect low viral levels? I doubt it.

Two cases -- a 14-year-old Turkish boy who died Sunday and his sister, 15, who died Thursday -- have been added to the WHO's list of confirmed H5N1 cases. At least nine other children from the same and nearby families have been hospitalized and are under investigation.

Two siblings of the dead children are in serious condition, on mechanical ventilators. And a doctor from the hospital where the suspect cases are being treated called in a local television interview for more ventilators to be sent to the region.

Note also the ridiculous suggestion later in the article that this may indicate a change in the virus, because more of those infected require ventilation. The timing for many of the clusters clearly indicated human to human transmission, with the later cases developing more slowly and in many cases having a milder illness. That is a striking similarity with many such zoonotic illnesses. They are not well adapted to human hosts, so illnesses derived from primary exposures are more lethal while human-to-human (H2H) transmission chains tend to die out. The timing in Turkey clearly shows that this was from primary exposure, because everyone seemed to have been hospitalized at about the same time.